Getting Frustrated

As I mentioned before I've have had a difficult time getting a call back from the pre-determination dept. at my doctor's office.  I finally spoke with Odalys on Tuesday and she assured me that my file was sent to my ins. co. for approval.  I thought "cool, I'm on my way", well today I got a return call from my ins. co. Anthem, Bariatric Dept. that they have not received anything from my doctor.
Where do I turn now???

call back and ask for sheila,,she is dr jawad's assistant

Donna
This is how I worked things, they work for you. You are the boss. Keep calling them, everyday and a couple times a day. You have to be a fight sometimes. I had to fight with my insurance till I talked to everyone at BCBS of Maryland. Fight and fight like mad, they work for you.
Hugs Kristen

Donna, insurance companies are huge and they lose papewrork all of the time,(sometimes I think on purpose, just to drag things out).  I have had to submit my paperwork two and three times over the years trying to get different things covered.  If they don't have it, then have your surgeons office resend it, certified with return receipt, and follow the package, the day they sign for it, call them and make sure someone starts looking for it.  Your surgeon's office may ***** a little about having to do things twice, but just let them know they are not going to get paid unless they do it, because until they do it, you can not have surgery.  Keep fighting, and don't let minor set backs frustrate you.

Good luck,

Steve

My suggestion would be to get a person's name and fax number at your insurance to send it to and then pick up the packet from your surgeon, then fax and fedex it yourself.  I would also ask the insurance company what their document handling processes are.  That may give you a clue where the hold up is.  Many times the packet gets to the insurance company and is sitting in a stack waiting to be scanned into the system.  Once scanned into the system it is routed to the appropriate office or person.  Until it gets scanned into the system it is not officially there.  If this is the case, It is not the fault of your docs office staff nor the insurance company staff -- it is just the system.  I can not know if that is what is going on but offer this as one possibility.  But on the off chance that someone dropped the ball -- you will have it covered --without antagonizing the people whom you want to help you.

Red

I just received a call from my insurance company and the nurse told me that they have been waiting for Dr. Jawad's office to return their call, because they sent my paper work in with two different medical codes.  One for the RNY and one for the Sleeve.  Dr. Jawad and I have never even discussed the sleeve, he is the one that told me the best procedure would be the RNY.  I assured the nurse that I was going with the RNY, so she accepted my response and now is able to proceed with my file.  She did tell me that she would have a decision for me today and it looks as though it will be approved.  She told me she wil call me first before the doctors office.
I may be seeing a light at the end of the tunnel.

I will keep everyone posted.

I have had huge issue with that office. I called several time, emailed several times. It's took about 2 month plus for it. It was ridiculous...and it only gets worse. When in doubt press 0, she's seems like she's the only one organized, besides the guy at the window that I can't remember his name but he cracks me up & I think he's great.....Anyway I can go on for hours with the issues I had with the office. But remember this Dr Jaward Kicks butt. He is an amazing surgeon. I can't say enough good things about him. So just keep on them constantly. And make sure you have the date in writing. They never change my address in the system (even though I gave it to them over the phone and in an email)  therefore I never received my itinerary and when I went to pre surgery info day, I had a different surgery date then they did. I know for fact the date I had was the one she have me over the phone because i put it into my calender on my computer when I was on the phone with her ...this effected my husbands vacation time (which he couldn't change) amongst other stuff. So GOOD LUCK!!!. I get me tube out tomorrow so it's the last time I have to see anybody until November. OH one more thing. If you need to get a refill on your pain med, make sure you have enough to last a few days. If it wasn't for the girl who answered the operator line, I would have went days without any.